Almost 14 months into Donald Trump’s presidency, there are still more than 200 top positions that are vacant or filled with an interim director. Among the agencies lacking permanent leadership are the U.S. Census Bureau, the Federal Highway Administration and the Food Safety and Inspection Service. As tensions with North Korea rise, the fact that the administration has yet to nominate someone to be the next ambassador for South Korea has attracted much controversy.

Though Trump’s pace of appointments is slower than that of the past three presidents, vacancies aren’t unique to the federal level.

In the first two months of 2018, five state Chief Information Officers -- from Kansas, Minnesota, Montana, Nevada and New Jersey -- left their jobs. With 36 gubernatorial races in November -- and 17 current governors not running for reelection -- many more CIOs are likely to quit or be pushed out if they get a new boss.

A graph of CIO tenure -- 31.5 months at last count -- is going to start looking like “an Olympic ski slope,” says Doug Robinson, executive director of the National Association of State Chief Information Officers (NASCIO). According to NASCIO data, tenure drops in the year of a big gubernatorial election and the one following it. From 2009 to 2011, CIO tenure fell from 37 to 33 to 24 months.

Of course, interim or acting directors usually keep operations going during the search for replacements, but they lack all the powers of permanent leaders. Mallory Barg Bulman, vice president of research and evaluation at the Partnership for Public Service, compares acting directors to substitute teachers.

“They don’t have formal authority. It’s very challenging … to lead without meaningful leadership teams in place,” she says.

When interim directors stay put for more than three months, Robinson says agencies can end up in limbo with major initiatives frozen. CIO positions, left unfilled, can be particularly troublesome at a time when many states are trying to implement new technology or IT processes.

“With an interim or acting CIO there’s less deliberate progress because they may not have the juice behind them,” he says. “There’s a sense that reform isn’t serious.”

State Medicaid directors, tasked with overseeing the health insurance program for lower-income people, have an even shorter average tenure than CIOs -- 19 months, according to the National Association of Medicaid Directors. The association doesn't track how long it takes to hire a replacement, but executive director Matt Salo says "it’s all over the map."

Sometimes, he says, a plan is already in place when the current director leaves and hiring is instantaneous. In other cases, an interim director can stay in the position for several years -- which is currently the case in Illinois.

There are a number of reasons why it’s difficult to find people to lead government departments.

For one, qualified candidates can often make much more money in the private sector. In March 2017, the Government Accountability Office (GAO) compared the total compensation of Medicaid directors to the top managed care executives with whom they often work. In the 10 states examined, the private executives made $314,278, on average, which is more than double Medicaid directors’ average pay of $152,439.

Money aside, people who take these jobs have to be willing to withstand constant criticism from within and outside of government. The work is strenuous and finding a work-life balance can seem impossible. Robinson recalls the following comment made to him by a chief information security officer who left his job for the private sector.

“He said, ‘Doug, I’ll make twice as much money and I’m going to work half as much. And it’s highly unlikely that my name will be in the front page of the paper.”

Hiring is also complicated when the decision is up to more than one official.

In Texas, for instance, Auditor John Keel announced his resignation in 2015. More than two years later, the job responsible for reviewing state finances and programs' effectiveness, is still empty. Off the record, government observers say this stagnation stems from the well-known tensions between the House speaker and the lieutenant governor, who must agree on who to appoint.

There’s at least one strategy that can speed up the replacement process, but it has its own drawbacks: hiring from within.

Appointing people from within increases the likelihood that a new leader will have a good understanding of the existing organizational culture. But when this happens, one vacancy often turns into another in a job-shifting round of musical chairs.

Oregon takes this approach: 70 percent of its recent vacancies were filled from inside rather than outside of the government, says Katy Coba, the state's chief operating officer, who estimates that about 20 high-level directors have left in the last two years.

For example, when the director of the Oregon Health Authority resigned in August, she was replaced by the director of the Department of Consumer and Business Services (DCBS). The director of the state Veterans’ Affairs Department (VA) then stepped into the head spot at DCBS. And now, the VA lacks a permanent leader.

“There is very much a domino effect,” says Coba.

In New Jersey, one of the few states where an attorney general is appointed rather than elected, an acting AG was in place for almost three years, between June 2013 and February 2016. Critics say the lag eliminated the state's checks and balances.

“Because of the state constitution’s special protections of independence for the attorney general, who might engage in an investigation of the governor, would not apply to an acting attorney general, the people of New Jersey are being denied those checks and balances,” according to an editorial in the New Jersey Law Journal.

The Supreme Court’s ruling was expected to diminish union membership. But so far, many unions have actually increased their numbers since the verdict. Conservative groups are working to reverse that trend in the long run.